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Methods: This retrospective cohort study analyzed AFP trajectories and their relationship with survival in HCC patients treated with bevacizumab plus immunotherapy from February 2021 to February 2023. Materials and Methods: 536 patients were classified by baseline AFP and modeled with a latent class approach; Cox regression and IPTW analyses assessed progression-free and overall survival. Results: Distinct AFP trajectories stratified outcomes, supporting AFP trajectory as an independent prognostic biomarker.",{"@graph":69,"@context":126},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/dynamic-changes-of-serum-fetoprotein-predict-the-prognosis-of-bevacizumab-plus-immunotherapy-in-hepatocellular-carcinoma/372076/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/dynamic-changes-of-serum-fetoprotein-predict-the-prognosis-of-bevacizumab-plus-immunotherapy-in-hepatocellular-carcinoma/372076.png","ImageObject",300,407,{"name":92,"@type":93},"Patrick","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-27","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118,122],{"name":109,"@type":110,"acceptedAnswer":111},"What is the study’s main question about AFP in HCC?","Question",{"text":112,"@type":113},"The study evaluates whether dynamic changes in serum alpha-fetoprotein (AFP) can predict prognosis in patients receiving bevacizumab plus immunotherapy for hepatocellular carcinoma.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were AFP trajectories determined in the study?",{"text":117,"@type":113},"Patients were grouped by baseline AFP value, and dynamic AFP changes were fitted using a latent class model to generate distinct AFP trajectory patterns.",{"name":119,"@type":110,"acceptedAnswer":120},"What endpoints were used to evaluate prognosis?",{"text":121,"@type":113},"Progression-free survival (PFS) was the primary endpoint, and overall survival (OS) was the second endpoint.",{"name":123,"@type":110,"acceptedAnswer":124},"What do the results suggest about AFP reduction after treatment?",{"text":125,"@type":113},"The findings indicate that certain AFP trajectory patterns—especially rapid reduction of AFP after treatment—are associated with more favorable patient prognoses.","https://schema.org",{"og:url":83,"og:type":128,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":130,"canonical":83},"index,follow",{"doc_id":132,"site_id":62},372076,1790876793,{"code":4,"msg":5,"data":135},{"doc_id":132,"user_id":136,"nickname":92,"user_avatar":137,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":138,"file_id":139,"file_url":140,"file_type":141,"file_size":142,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":52,"language":143,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":144,"faqs":145,"seo_title":146,"seo_description":67,"update_tm":147,"read_time":148},549758146520,"https://ap-avatar.wpscdn.com/avatar/80002397d8c0411e94?_k=1775819394049821470","’Retrospective Cohort Study  \nDynamic changes of serum α-fetoprotein predict the prognosis of bevacizumab plus immunotherapy in hepatocellular carcinoma  \nZhenyun Yang, MDa,b,c , Yizhen Fu, MD, PhDa,b,c , Qianyu Wang, MDd , Yangxun Pan, MD, PhDa,b,c ,  \nJuncheng Wang, MD, PhDa,b,c , Jinbin Chen, MD, PhDa,b,c , Dandan Hu, MD, PhDa,b,c , Zhongguo Zhou, MD, PhDa,b,c , Minshan Chen, MD, PhDa,b,c,*, Yaojun Zhang, MD, PhDa,b,c,*  \nBackground: Alpha-fetoprotein (AFP) has been established as a biomarker for hepatocellular carcinoma (HCC); however, whether its dynamic changes could predict the response to systemic therapy remains elusive. This study explored the AFP trajectory and the association with survival in patients who received bevacizumab plus immunotherapy.  \nMaterials and Methods: We retrospectively enrolled 536 HCC patients who received bevacizumab plus immunotherapy between February 2021 and February 2023 . Patients were divided into two groups according to AFP values before treatment (400 ng/ml) . Dynamic changes ofAFP were fitted using a latent class model to generate the AFP trajectories. Multivariable Cox models were utilized to compute hazard ratios (HRs) for survival. Inverse-probability-of-treatment weighted analyses were conducted to mitigate the influence ofunmeasured confounding variables. The primary endpoint is progression-free survival (PFS) . The second endpoint is overall survival (OS) . Results: Three distinct trajectories were identified for AFP-low and AFP-high patients, respectively. In the AFP-low group, compared with the high-rising class (25%; n = 69), HRs of PFS were 0 .39 and 0 .2 for the low-stable class (59 . 1%; n = 163) and sharp-falling class (15 .9%; n = 44), after adjusting by tumor diameter, tumor number, and extra-hepatic metastasis. In the AFP-high group, compared with the high-stable class (18 .5%; n = 48), HRs of PFS were 0 .3 and 0 .04 for the middle-stable class (56 .5%; n = 147) and sharp-falling class (25%; n = 65), after adjusting by tumor diameter, tumor number, and extra-hepatic metastasis. Furthermore, the AFP trajectories exhibited the utmost relative importance among all covariates regarding PFS and OS in the multivariable regression models. Conclusion: The AFP trajectories in HCC patients receiving bevacizumab and immunotherapy constituted an independent biomarker indicative of clinical outcomes. Findings from this study hold potential clinical utility in dynamically forecasting the prognosis of systemic therapy in HCC patients and facilitating clinical decision-making. Rapid reduction of AFP post-treatment can lead to favorable patient prognoses.  \nKeywords: AFP trajectory, bevacizumab, hepatocellular carcinoma, immunotherapy, survival  \nIntroduction  \nHepatocellular carcinoma (HCC) emerges as a preeminent malignant neoplasm on a global scale and holds a position among the top three leading causes of cancer-related mortality[1] . In light  \nof current circumstances, prognostic models suggest an excess of one million novel instances of HCC, and a commensurate number of HCC-associated deaths are envisaged by the year 2040[2] . Unfortunately, due to the clandestine onset of HCC, a significant  \naDepartment of Liver Surgery, Sun Yat-sen University Cancer Center, bCollaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, cGuangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong and dKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Molecular Oncology, Peking University Cancer Hospital and Institute, Beijing, People ’s Republic of China  \nZhenyun Yang, Yizhen Fu, and Qianyu Wang have contributed equally to this work and should be considered joint first authors.  \nSponsorships or competing interests that may be relevant to content are disclosed at the end of this article.  \n*Corresponding auth","cbCaiqeGGJpwSmAJ","https://ap.wps.com/l/cbCaiqeGGJpwSmAJ","pdf",847958,"English","# Background\n# Materials and Methods\n# Results\n# Conclusion\n# Keywords","[{\"question\":\"What is the study’s main question about AFP in HCC?\",\"answer\":\"The study evaluates whether dynamic changes in serum alpha-fetoprotein (AFP) can predict prognosis in patients receiving bevacizumab plus immunotherapy for hepatocellular carcinoma.\"},{\"question\":\"How were AFP trajectories determined in the study?\",\"answer\":\"Patients were grouped by baseline AFP value, and dynamic AFP changes were fitted using a latent class model to generate distinct AFP trajectory patterns.\"},{\"question\":\"What endpoints were used to evaluate prognosis?\",\"answer\":\"Progression-free survival (PFS) was the primary endpoint, and overall survival (OS) was the second endpoint.\"},{\"question\":\"What do the results suggest about AFP reduction after treatment?\",\"answer\":\"The findings indicate that certain AFP trajectory patterns—especially rapid reduction of AFP after treatment—are associated with more favorable patient prognoses.\"}]","Dynamic changes of serum α-fetoprotein predict the prognosis of bevacizumab plus immunotherapy in hepatocellular carcinoma | PDF",1790193649,25]